Drug Index


Synonym :

Succinyl Choline

Mechanism :

Succinylcholine is a depolarizing skeletal muscle relaxant. As does acetylcholine, it combines with the cholinergic receptors of the motor end plate to produce depolarization. This depolarization may be observed as fasciculations. Subsequent neuromuscular transmission is inhibited so long as adequate concentration of succinylcholine remains at the receptor site.

Indication :

• Neuromuscular blockade for tracheal intubation

Contraindications :

Succinylcholine is contraindicated in persons with personal or familial history of malignant hyperthermia, skeletal muscle myopathies, known hypersensitivity to the drug, in patients after the acute phase of injury following major burns, multiple trauma, extensive denervation of skeletal muscle, or upper motor neuron injury, because succinylcholine administered to such individuals may result in severe hyperkalemia which may result in cardiac arrest.

Dosing :

Infants and smaller children: 2 mg/kg IV single dose.

Adolescents: 1 mg/kg IV single dose or 3-4 mg/kg deep IM. Max: 150 mg.

Maintenance: 0.3-0.6 mg/kg IV every 5-10 mins as needed.

Adverse Effect :

Succinylcholine causes profound muscle relaxation resulting in respiratory depression to the point of apnea. Hypersensitivity reactions, including anaphylaxis, may occur in rare instances. The following additional adverse reactions have been reported: cardiac arrest, malignant hyperthermia, arrhythmias, bradycardia, tachycardia, hypertension, hypotension, hyperkalemia, prolonged respiratory depression or apnea, increased intraocular pressure, muscle fasciculation, jaw rigidity, postoperative muscle pain, rhabdomyolysis with possible myoglobinuric acute renal failure, salivary gland enlargement, excessive salivation,
and rash.

Interaction :

Promazine, Oxytocin, Aprotinin, Certain Non-Penicillin Antibiotics, Quinidine, B-Adrenergic Blockers, Procainamide, Lidocaine, Trimethaphan, Lithium Carbonate, Magnesium Salts, Quinine, Chloroquine, Diethyl Ether, Isoflurane, Desflurane, Metoclopramide, and Terbutaline: May enhance the neuromuscular blocking action of succinylcholine.
Chronically administered oral contraceptives, glucocorticoids, or certain Monoamine Oxidase Inhibitors: The neuromuscular blocking effect of succinylcholine may be enhanced by drugs that reduce plasma cholinesterase activity.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function. Use with caution.

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnknown dialysability. Dose as in GFR<10 mL/min
HDUnknown dialysability. Dose as in GFR<10 mL/min
HDF/High fluxUnknown dialysability. Dose as in GFR<10 mL/min
CAV/VVHDUnknown dialysability. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are recommended.
05/30/2020 06:25:38 Suxamethonium
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